No 2- Learning Medicine AFAP (As Fast As Possible)
Tldr (Too Long Didn’t Read) Summary
If you are involved in healthcare then studying medicine and the latest science is a career/ life long task. You need to learn to work smart, as well as hard. This is the first article of mine on how to learn medicine AFAP (as fast as possible).
Healthcare is not just a job.
Are you a medical student? A junior doctor? A senior nurse? A brand new physiotherapist? Or a dietician about to retire?
Firstly, thank you for taking 5 minutes to read this article and to invest in your own medical education. Who ever you are, it doesn’t really matter. Why doesn’t it matter?
This first article for anyone who wants to learn some quick tips on how to study and learn faster. This should be relevant to anyone at any stage of their career. It is especially relevant to those in healthcare who have to do life long learning for their entire careers!
Healthcare and science are expanding exponentially.
As competent healthcare professionals we all want to do the best job we can for our patients (cliché I know!), and this requires us to know about the latest diagnostic tests, the latest updates on treatments and the latest guidance.
The problem is that “medicine” is just too big a subject for any one individual to know it all.
This means that we have to specialise and focus on some areas and hope that our knowledge of other areas stays mostly correct. We also need to work in teams and hope that our colleagues know more than we do about some subjects.
The other major issue with staying up to date is this … the number of publications is expanding at an exponential rate each year. So even if you super sub specialise in the skin conditions of the left eye brow, it will still be impossible to read every single new article that is published as well as do your day job and sleep.
The number of articles being published and studies being conducted is vast but maybe surprisingly, this doesn’t necessarily translate into a lot of change in day to day medicine. This is a whole topic for another day but the take home is that you DO NOT need to read every new paper that is published.
Bouncy tips for Med Ed AFAP
1. "Bounce" by Matthew Syed. Any professional that is interested in their own development should read this book. He has spent years learning about “how to learn” from some of the top sports stars and professionals in the world and he has some really good thoughts on Med Ed that I am going to paraphrase below and add my own spin too.
2. Medicine is mostly pattern recognition. These symptoms have a such and such percentage probability of being this disease, or these symptoms normally improve with this treatment. Therefore, you need to get good at recognising the patterns.
3. Repetition. Unfortunately there are no cheat-codes or magic bullets that allow you to store facts (patterns) as memories without some repetition. You have to accept that some subjects just won’t stay in your head unless you are a genetic freak and very lucky to have a photographic memory or you are willing to put in the work at building those memories. Use it or lose it!
4. Intensity. Memories form faster and are more likely to stick if they are associated with emotions and/or rewards or punishments. If you can make a fact interesting then it is more likely to stick.
5. Variety. Everyone learns differently but there is a simple point that is relevant to everyone and that is the “law of diminishing returns”. If you have spent 2h reading a textbook, then spending another 2h reading it will almost certainly be a waste of time because the text you are reading will just be pushing the stuff you just read out of your Short Term Memory (STM) before it is converted into Long Term Memory (LTM). This feels like hard work. It feels productive. It feels like what you should be doing but it is in fact counter productive and a waste of time. So add a little variety because doing something different will force your brain to stay active and tuned in.
6. Short Term Feedback. People learn best when their action or choice has immediately results. This immediacy triggers chemicals in the brain which stimulate synapses and cause memories to be formed far more intensely. The issue with the old style of Med Ed is that you go to a lecture or a hospital and you “learn stuff” by “absorbing it” and then you get tested every few months to see if you have learnt it. This involves very delayed results and does not help you form strong memories.
7. Bring these points together! I have spent a few years thinking about this and have tried to develop a few habits to help me learn medicine.
8. Tiny Habits by BJ Fogg. Regular behaviour becomes a habit and good habits get you towards your goals. The best intervention you can make in your life is to work out what your goals are and then turn them into tiny habits than you can do in a couple of seconds daily. Read below for my Tiny Habits:
9. Read “medicine” daily. For about 6 months now, one of my daily Tiny Habits has been to open a medical textbook and try to read at least 1 page a day. I give myself a pat on the back even if I just pick up and open the textbook and it usually leads to me reading at least a page.
10. Listen to medical and science podcasts. There are hundreds of these from various sources but they allow variety and multitasking because you can do this while you exercise, do chores, commute, look after your kids or just as you fall asleep on the sofa. It’s a good way to get a brief over view of a range of topics. Future articles will cover podcasts that I strongly recommend.
11. Sign up for newsletters. If you are based in the UK sign up for NICE updates, SIGN updates, Cochrane Review updates, QxMD, RedWhale, Doctor Penguin Weekly, Royal College etc etc. You don’t have to read every single email but I try to pick 1 article per email and give it a quick scan. This means that you are always aware of the latest guideline changes, which means that you don’t need to read the latest papers. Remember guidelines may not always be “the best” treatment for your patient but they are “safety in numbers” so if you follow them you probably won’t go to far wrong and you save yourself a lot of searching on PubMed.
12. Online Question Banks. I believe that online question banks are the future of medical education. In the UK, medical students and doctors tend to pay to use these services a few months before an exam. They spend hours each day cramming questions and answers in the hope that they can learn everything common that will be on the exam. This works! It works because question banks give you “instant feedback”, they give you a dopamine rush when you are right, they make you sad when you are wrong (emotions and rewards), keeping score on the system turns it into a game which keeps it interesting, they recap things you got wrong, they allow your to focus and they change topic to keep you interested. The “game-ification” of Med Ed is the future because it will allow people to learn faster and make stronger LTM, allowing them to retain more pattern recognition facts and hopefully be better clinicians. For the last year, I have tried to log on everyday and complete at least 10 questions. Use the Tiny Habits method to get into the habit of doing daily questions and then over the months you will cover a vast amount of medicine and hopefully the repetition will build those memory banks of yours.
Thank you for getting to the end of this first article in this series. I intend to do quite a few more because I believe that the topic of “how to learn medicine efficiently” is an under studied and under discussed topic. Please let me know your thoughts in the comments below and let me know if you thought this was useful – feedback (as quickly as possible) is always good.
(Rule 3 Word count – 1421, not quite as brief today, sorry but its an important topic).